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1376486746 NPI number — GRACEFUL RESILIENCE COUNSELING & COMMUNITY SERVICES, LLC

NPI Number: 1376486746
Health Care Provider/Practitioner: GRACEFUL RESILIENCE COUNSELING & COMMUNITY SERVICES, LLC

Information about “1376486746” NPI (GRACEFUL RESILIENCE COUNSELING & COMMUNITY SERVICES, LLC) exists in 1376486746 in HTML format HTML  |  1376486746 in plain Text format TXT  |  1376486746 in PDF (Portable Document Format) PDF  |  1376486746 in an XML format XML  formats.

NPI Number : 1376486746 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1376486746",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GRACEFUL RESILIENCE COUNSELING & COMMUNITY SERVICES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "62 WESTWOOD DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "STURBRIDGE",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01566-1348",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "774-321-5620",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "62 WESTWOOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "STURBRIDGE",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01566-1348",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "774-321-5620",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/10/2026",
    "LastUpdateDate": "04/11/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WATSON MALAVE",
    "AuthorizedOfficialFirstName": "JOMARIE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER / SOLE MEMBER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MSW INTERN",
    "AuthorizedOfficialTelephoneNumber": "774-321-5620",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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